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In a separate report, Andrade-Campos et al. [950] compared IgM HLC results from 19 WM patients and 32 asymptomatic WM with those of 39 IgM MGUS patients. The median involved/uninvolved HLC ratio was significantly higher in WM (117.5), than asymptomatic WM (62.1) or IgM MGUS (16.1; p=0.0002) patients. Furthermore, the proportion of patients with HLC pair suppression was significantly higher in WM (83.3%) and asymptomatic WM (64.3%) than IgM MGUS (46.2%, both p=0.0002). Further work is now required to study the combined use of FLC and HLC analysis to better discriminate WM and IgM MGUS.

An initial study of the prognostic value of sFLCs in
asymptomatic WM by Kastritis et al. [997] concluded that an abnormal sFLC ratio was not associated with a higher risk of
progression, but that bone marrow infiltration and a low haemoglobin were major risk
factors for progression to symptomatic disease.

Questions

Why are sFLCs useful for monitoring WM patients with cryoglobulinaemia?